Provider Demographics
NPI:1053926931
Name:JANE MENDELSOHN MSW LMSW LLC
Entity type:Organization
Organization Name:JANE MENDELSOHN MSW LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDELSOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LMSW
Authorized Official - Phone:248-909-3567
Mailing Address - Street 1:32400 OLDE FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1740
Mailing Address - Country:US
Mailing Address - Phone:248-909-3567
Mailing Address - Fax:248-658-8777
Practice Address - Street 1:32400 OLDE FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1740
Practice Address - Country:US
Practice Address - Phone:248-909-3567
Practice Address - Fax:248-658-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty